非精神科医生对精神科医生的期望：来自农村医疗系统病历审查咨询请求的数据。
What Nonpsychiatrists Want From Psychiatrists: Data From Chart Review Consultation Requests in a Rural Health Care System.
作者信息
Calvo Evan M, Walsh Lauren K, Tyrell Victoria M T, Chabris Christopher F, Byars Joanne A
机构信息
Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania (Calvo, Tyrell, Byars); Department of Developmental Medicine, Geisinger Research Institute, Lewisburg, Pennsylvania (Walsh); Department of Psychiatry and Behavioral Health (Tyrell, Byars) and Department of Bioethics and Decision Sciences (Chabris), Geisinger Research Institute, Danville, Pennsylvania.
出版信息
Psychiatr Serv. 2025 Aug 1;76(8):760-763. doi: 10.1176/appi.ps.20240263. Epub 2025 May 28.
OBJECTIVE
Given the growing need for novel psychiatric service delivery, this study sought to characterize the use of an outpatient electronic consultation service, Ask-A-Doc (AAD), in a rural health care system.
METHODS
A qualitative codebook was developed (final interrater agreement=92%) and applied to the free text of all AAD questions (N=707) received by a psychiatry department during a 12-month period.
RESULTS
Primary care was the principal source of AAD questions (95%), with most submitted by physicians (56%) and advanced practitioners (44%). Medication management was the most common reason for AAD submission (90%). Submissions mentioned psychiatric symptoms (85%) more than diagnoses (52%). Commonly mentioned symptoms included anxiety and depression; frequently mentioned diagnoses included bipolar disorder, attention-deficit hyperactivity disorder, and major depressive disorder.
CONCLUSIONS
Nonpsychiatrists find benefit in psychiatrist assistance in managing patients with mental health conditions; they generally want recommendations for medication management to target specific symptoms, not assistance with making or treating specific diagnoses.
目的
鉴于对新型精神科服务提供的需求不断增长，本研究旨在描述农村医疗系统中门诊电子咨询服务“问医生”（Ask-A-Doc，AAD）的使用情况。
方法
制定了一个定性编码手册（最终评分者间一致性为92%），并应用于精神科在12个月期间收到的所有AAD问题（N = 707）的自由文本。
结果
初级保健是AAD问题的主要来源（95%），大多数问题由医生（56%）和高级执业人员（44%）提交。药物管理是提交AAD问题的最常见原因（90%）。提交的问题提及精神症状（85%）多于诊断（52%）。常见提及的症状包括焦虑和抑郁；经常提及的诊断包括双相情感障碍、注意力缺陷多动障碍和重度抑郁症。
结论
非精神科医生发现在管理心理健康状况患者方面获得精神科医生的帮助有益；他们通常希望获得针对特定症状的药物管理建议，而非进行特定诊断或治疗的帮助。
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